Modernising Pharmacy Careers Programme. Review of Post-Registration Career Development of Pharmacists and Pharmacy Technicians

Transcription

1 Modernising Pharmacy Careers Programme Review of Post-Registration Career Development of Pharmacists and Pharmacy Technicians Background paper July 2012 Helen Howe and Keith Wilson

2 Foreword The purpose of the Modernising Pharmacy Careers (MPC) review of post registration career development of pharmacist and pharmacy technicians is to develop a strategic direction for the career development of the pharmacy team. This is not so the profession grows in itself, but for the benefit to patients. Professional growth, as a trained and motivated workforce, will enable us to deliver improved patient care and reduce medication-related risk. This must be in the most costeffective way, to maximise use of that significant part of the health budget committed to medicines and their use. Future healthcare will not tread the same steps of the past, and change will take time. For our part, it is key that we carefully consider how we are to transform our profession to ensure it becomes a clinical partner, with responsibilities for optimising medicines use, not just safe supply. Patient care will in the future look different, with patients exercising more choice and control of their healthcare, and much of it community led, with increased numbers of patients with long term medical conditions needing clinical support. It has become clear over the course of the review that the post-registration work of MPC is much more complex and wider in scope than originally anticipated. In retrospect, this is not surprising since it is the first time that postgraduate pharmacy education has been comprehensively examined. However, it demonstrates the need to develop a common understanding of the issues and needs for post-registration education and training across the workforce before proposing recommendations or options for change. Furthermore, it has also become clear that emerging areas of policy, such as supervision of the sale and supply of medicines, have implications for the review. Without a reasonable degree of consensus on the issues, it will be difficult to gain support from stakeholders for moving forward and developing potential solutions or recommendations. This paper provides the picture of the current landscape and some of the constraints on career development. It is intended to provide that background, so that other supporting, focused pieces of work can provide possible ways forward in terms of changes to career development, for discussion within and beyond the profession of pharmacy. Initial discussion with pharmacy stakeholders will seek to establish common ownership of a future programme of work, to address four or five key areas that will prepare the profession for the future. This work programme will seek to build on the MPC work that has already been undertaken to transform the undergraduate preparation for registration as a pharmacist. MPC will present the issues that have been identified from the post-registration work to date, in order to engage stakeholders and discuss appropriate next steps in seeking resolution, progress, or simply recognition that change is needed in agreed areas of pharmacy. This future work programme will take place under the governance of the Health Education England (HEE) Board. MPC, and what follows it in terms of professional 2

3 advisory support to HEE from pharmacy, will address the programme with input from professional bodies, regulators, employers and other stakeholders. We hope this paper is helpful, especially to non-pharmacy team colleagues, in describing where we are, some of the reasons why we are there, and in identifying the issues we will develop further in separate papers. Helen Howe Chief Pharmacist, Cambridge University Hospitals NHS Foundation Trust Keith Wilson Professor of Pharmacy Practice, University of Aston 3

4 CONTENTS 1. BACKGROUND 8 Optimising medicines use 8 New services in community pharmacy 9 Long term conditions 10 Public health and well being 11 Healthy Living Pharmacies PROFESSIONAL DEVELOPMENT AND REGULATION 12 The roles of the regulator, professional leadership bodies and representative organisations 12 How the career of a registered professional develops CAREER PATHWAYS OF REGISTERED PHARMACY PROFESSIONALS 15 Current arrangements for education, training and registration of pharmacists 15 Current arrangements for education, training and registration of pharmacy technicians 16 Roles and responsibilities of the registered pharmacy workforce 17 Responsible Pharmacist regulations and supervision 18 Post-registration career development 19 NHS managed care 19 Community 20 Primary care 20 Technical and scientific services 21 Academia 22 Locum workforce 23 Workforce planning 24 Moving from novice to expert and beyond Advanced, Specialist, Pharmacists with a Special Interest, Prescribers 24 Advanced practice and consultant pharmacists 26 Pharmacist Independent Prescribers 27 Specialist roles 28 Pharmacists with Special Interests CURRENT LANDSCAPE IN PHARMACY EDUCATION AND TRAINING 30 Education and training provision - community 30 4

5 Education and training provision - hospital and managed care 31 Education and training provision - primary care 31 Education and training provision - pharmacy technicians 32 Education and training provision - academia 32 Education and training provision - clinical and technical science 33 Industry 33 Education and training providers - CPPE 33 Pharmacy Deaneries 34 Professional groups with education and training remit 34 NHS Pharmacy Education and Development Committee (PEDC) 34 Technical Specialist Education and Training (TSET) Group 35 Royal Pharmaceutical Society (RPS) 35 Association of Pharmacy Technicians UK (APTUK) PROFESSIONAL DEVELOPMENT AND COMPETENCY FRAMEWORKS IN PHARMACY 37 Key frameworks currently used in pharmacy 38 Accreditation frameworks to support extended roles 38 Competency frameworks to support professional development 39 General Level Framework (GLF) 39 Advanced to Consultant Level Framework (ACLF) 39 Framework for Pharmacy Technicians 40 Leadership development frameworks 40 Independent evaluation of frameworks for professional development in pharmacy in the UK 43 Key findings of the research report PHARMACY RESEARCH 45 Pharmaceutical science 45 Clinical research and trials 45 Pharmacy practice research 45 Inter-disciplinary health research 45 Career of the post-registration pharmacy professional and exposure to research 46 Infrastructure for research and evaluation in pharmacy practice 47 Current research skills and training requirements in practice 48 Community pharmacy practice 48 Clinical Research Requirements PHARMACY TECHNICIANS AS A NEW PROFESSION ISSUES IDENTIFIED IN THE CURRENT POST-REGISTRATION PHARMACY WORKFORCE 51 5

6 4.1 GREATER CLINICAL CARE AND SERVICES BY THE PHARMACY TEAM REQUIRES STAFF TO HAVE THE NECESSARY CORE COMPETENCIES AND SUCH SERVICES TO BE COMMISSIONED LACK OF A STRUCTURED CAREER PATHWAY TO MOVE FROM NOVICE TO EXPERT, AND BEYOND 54 Locum pharmacists SEPARATION OF PHARMACY CAREERS AT AN EARLY STAGE FROM INDIVIDUAL SECTORS AND FROM OTHER HEALTHCARE PROFESSIONS 56 Separation of pharmacy careers at an early stage between the hospital and community sectors 56 Separation of clinical technical specialist roles from other parts of pharmacy 57 Separation of pharmacy practitioners and other healthcare professions PHARMACISTS AND PHARMACY TECHNICIANS WORKING TOGETHER AS TWO COMPLEMENTARY PROFESSIONS WITH IMPLICATIONS FOR ROLES, RESPONSIBILITIES, SKILL MIX AND WORKFORCE PLANNING ACROSS THE PHARMACY TEAM 59 Workforce planning and skillmix SUPPLY SIDE SHORTAGES IN KEY SECTORS, E.G. PHARMACISTS IN ACADEMIA, RESEARCH AND CLINICAL SPECIALTIES 62 Supply side shortages in academia 62 Lack of doctoral (PhD) and post-doctoral opportunities 62 Lack of support for practising pharmacists in academia 63 Supply side shortages in clinical technical specialties 63 Supply side shortages of Qualified Persons RESEARCH NEEDS TO BE AT THE CORE OF PHARMACY PRACTICE ACROSS ALL SECTORS TO ADD TO KNOWLEDGE, AND ENGENDER A CULTURE OF LIFELONG TEACHING AND LEARNING AMONG PHARMACY PROFESSIONALS 65 Lack of research capacity and culture within higher education institutions (HEIs) 65 Funding 65 The importance of research in healthcare policy and practice 66 Constraints in post-registration education and training 66 The near absence of research in the practice of pharmacy 67 Impact on ability to develop advanced/consultant roles 68 6

7 APPENDIX A METHODOLOGY 69 ANNEX B REVIEW TEAM MEMBERS 74 ANNEX C EXPERT PANEL MEMBERS AND ADVISORY GROUP MEMBERS FOR INDEPENDENT EVALUATION OF THE ROLE, DEVELOPMENT AND IMPLEMENTATION OF FRAMEWORKS FOR POST-REGISTRATION PROFESSIONAL DEVELOPMENT IN PHARMACY 77 7

8 1. Background The Modernising Pharmacy Careers (MPC) programme, launched in February 2009, is designed to ensure the pharmacy workforce has the knowledge, skills and capacities to deliver the services of the future for patients and the public. It is setting out a strategic direction for education, training, and workforce planning across all sectors and staff groups in pharmacy. In January 2011 MPC initiated a comprehensive review of current arrangements for post registration pharmacy career progression. Career development pathways for pharmacy professionals after registration are not well defined and there is potential for improvement so that the pharmacy workforce has the knowledge, confidence and skill-set to deliver more efficient, safer and higher quality care to patients and the public, particularly in relation to better use of medicines. Over the last few decades the practice of pharmacy has evolved to varying degrees from a predominantly dispensing and supply function to a greater emphasis on clinical input, delivering new services for patients and playing a greater role in public health initiatives. Medicines themselves and the way they are used are set to change as the promise of pharmacogenomics and molecular biology begins to materialise, allowing medicines use to be personalised. The future for pharmacy practice will see pharmacists, pharmacy technicians and the wider pharmacy team drawing on their individual clinical and communication skills to work with other healthcare professionals and patients to optimise the use of medicines in a healthy living environment. Optimising medicines use Medicines are at the heart of modern healthcare and remain the most common treatment offered to patients. After salary costs, medicines are the single highest outlay by the National Health Service (NHS) (an estimated 12.5 billion in 2010/11). The number of prescription items dispensed by community pharmacies in England in was million. Prescription volumes are increasing 4-5% year on year due to an ageing population and an increase in the extent of long term conditions and co-morbidities. As experts in medicines, pharmacists and pharmacy technicians are best placed to encourage and embed safe and effective use of medicines. In an outcome-driven health service, society needs to get maximum effectiveness and value from its investment in medicines, particularly in the current economic environment, and it is clear that there is scope for improvement in the effective use of medicines: Avoidable medicines wastage in primary care is running at about 150 million per year 1 ; 1 York Health Economics Consortium/School of Pharmacy, University of London, (2010) Evaluation of the Scale, Causes and Costs of Waste Medicines. 8

9 The National Institute for Health and Clinical Excellence reports that 30 50% of medicines are not being taken as intended, resulting in a loss in health gain of billions of pounds 2 ; Preventable adverse effects of medicines account for 4 5% of all hospital admissions 3 ; The Care Home Use of Medicines Study found an unacceptable level of errors in prescribing, dispensing, drug administration and drug monitoring when medicines are used in care homes 4 ; The General Medical Council s (GMC s) EQUIP study demonstrated an unacceptable level of prescribing error across all grades of hospital doctors 5. New services in community pharmacy The last decade has seen a large increase in the provision of enhanced services from community pharmacy contractors, such as: smoking cessation support; supervised administration of medicines; minor ailment schemes; and supply via patient group directions - a trend that is likely to continue (see Figure 1). A New Medicines Service (NMS) 6 was launched in England in October 2011, with time limited funding until March This is designed to provide early support to patients to maximise the benefits of the medication they have been prescribed. Pharmacists and their teams are required to demonstrate that the service is cost effective and has a clear benefit to patients if it is to continue. Emerging services in community pharmacies include vaccination and anticoagulation monitoring. If the expectation of policy makers, commissioners and employers is that such enhanced services become the standard across the UK, this will drive the education and training needs of the current and future pharmacy workforce. 2 Horne R, Weinman J, Barber N et al. (2005) Concordance, adherence and compliance in medicine taking, Report for the National Co-ordinating Centre for NHS Service Delivery and Organisation R&D (NCCSDO). 3 Pirmohamed M, James S, Meakin S et al, Adverse drug reactions as a cause of admission to hospital: prospective analysis of 18,820 patients, British Medical Journal 2004, 329, pp Alldred DP, Barber N, Buckle P et al. (2009) The Care Home Use of Medicines Study. 5 Dornan T, Ashcroft D, Heathfield H et al. (2009) An in-depth investigation into causes of prescribing errors by foundation trainees in relation to their medical education, EQUIP study. 6 Department of Health, (2011) Impact Assessment on the Introduction of the New Medicine Service, Available: [6 Mar 2012]. 9

10 Figure 1. Number of pharmacies in contract for Enhanced Services 7 Long term conditions Some 15 million people in England live with a long-term condition 8 and the number affected is set to rise by 25% over the next 25 years. 9 Medicines play a life-saving and life-changing role in the management of these long-term conditions, as treatment is estimated to account for 7 in every 10 of total health and social care spending in England. However, there is clear evidence that anywhere between 30% and 50% of patients do not take their medicines as intended by the prescriber. 10 As the majority of patients with long term conditions are managed in the community, pharmacists, pharmacy technicians and the pharmacy team have a key role to play in supporting such patients to self-manage their care and gain maximum benefit from their medicines. 7 General Pharmaceutical Services in England and Wales, NHS Information Centre (Nov 2009); as cited in Delivering Enhanced Pharmacy Services in a Modern NHS: Improving Outcomes in Public Health and Long Term Conditions, The Bow Group Health Policy Committee, (2010) Target Paper, p Department of Health, [6 Mar 2012]. 9 Technology Strategy Board, (2009) Managing long-term conditions remote monitoring, [6 Mar 2012]. 10 Horne R, Weinman J, Barber N et al. (2005) Concordance, adherence and compliance in medicine taking: Report for the National Co-ordinating Centre for NHS Service Delivery and Organisation R&D (NCCSDO). 10

11 The Medicine Use Review and prescription intervention service, introduced in 2005, provides a structured framework to support pharmacists who have achieved the necessary accreditation in this role. Public health and well being Demographic change and the public health challenges of obesity, sexual health, alcohol use and smoking-related illness alone will increase the cost of healthcare by an estimated 1.4 billion a year for the next few years. 11 In the community, where 96% of the population can reach a pharmacy within 20 minutes, we are already seeing pharmacies and their teams becoming more involved in public health initiatives. 12 Pharmacists, pharmacy technicians and assistants are delivering a range of public health interventions such as smoking cessation and sexual health services. Healthy Living Pharmacies In a number of areas across the country, the concept of Healthy Living Pharmacies (HLPs) is helping reduce health inequalities and improve people s health outcomes by promoting high quality health and well being services and providing proactive health advice and interventions. 13 A qualified Health Champion supports the health and wellbeing role of the HLP - this is a suitable role for a pharmacy technician or a medicines counter assistant. Services commissioned from the HLP are informed by their primary care trust s (PCT) pharmaceutical needs assessment (PNA), and vary according to local health needs. Smoking cessation and sexual health services proved particularly effective in the first HLPs piloted in Portsmouth. Outcomes from these include: 140% increase in smoking quits from pharmacies compared with the previous year; 75% of the 200 smokers with asthma or chronic obstructive pulmonary disease who had a medicines use review (MUR) accepted help to stop smoking; 3,450 consultations for emergency hormonal contraception through 32 pharmacies. Following the success of HLPs in Portsmouth, a HLP pathfinder programme, supported by the Department of Health, is now being rolled out across 20 pathfinder areas (covering 30 PCTs) to evaluate the impact on areas with different demographics. Over 190 individual pharmacies, including non-pathfinder areas, had been accredited as HLPs as at the end of March King s Fund/Institute for Fiscal Studies, (2009) How cold will it be? Prospects for NHS funding, pp The Bow Group Health Policy Committee (2010) Delivering Enhanced Pharmacy Services in a Modern NHS: Improving outcomes in public health and long-term conditions. 13 Pharmaceutical Services Negotiating Committee, (2011) Twenty Healthy Living Pharmacy pathfinder sites announced, Available: [15 Feb 2012] 14 National Pharmacy Association, Healthy Living Pharmacies: overview, Available: [15 Feb 2012] 11

12 2. Professional development and regulation The roles of the regulator, professional leadership bodies and representative organisations In England, Scotland and Wales, the pharmacy register is held by the General Pharmaceutical Council (GPhC). 15 The role of the GPhC as the pharmacy regulator is to ensure minimum standards for pharmacy professionals and regulate pharmacists with prescribing responsibilities; providing protection for patients by ensuring only those qualified, competent and under a duty to maintain high standards can work as pharmacists and pharmacy technicians. As roles and responsibilities change, the regulation of pharmacists and pharmacy technicians will need to adapt to reflect this fundamental role. The GPhC requires that all pharmacists and pharmacy technicians renew their registration on an annual basis. To do this they must indicate that they have met continuing professional development (CPD) requirements, as well as health, fitness to practice and ethical standards. Failure of an individual to renew their registration means they are no longer entitled to practise. 16 The GPhC recently took the decision to develop a revalidation process and agreed a draft definition of revalidation, along with a draft set of principles. It defines revalidation as: The process by which assurance of continuing fitness to practise of registrants is provided and in a way which is aimed primarily at supporting and enhancing professional practice. 17 The primary role of a regulatory body is to protect the public through setting and enforcing educational standards for entry to the register and continued registration, and minimum standards of professional practice, proficiency and conduct. 18 The GPhC has statutory powers that derive from the Pharmacy Order and these are the basis for its fitness to practice procedures. In 2010 when the regulatory function was devolved from the Royal Pharmaceutical Society of Great Britain (RPSGB), the Royal Pharmaceutical Society (RPS) became the professional leadership body for pharmacists. The Association for Pharmacy Technicians UK (APTUK) is the professional leadership body for pharmacy technicians and was formed in In pharmacy, the interests of individuals are represented by a number of organisations including: the Pharmacists Defence Association; the Guild of Healthcare Pharmacists; Unite; and Unison. There are also organisations representing the interests of pharmacy owners/contractors, such as the 15 General Pharmaceutical Council, (2011) Factsheet 1 General Pharmaceutical Council, Available: [23 Jan 2012]. 16 General Pharmaceutical Council, (2011) Factsheet 1 General Pharmaceutical Council, Available: 17 General Pharmaceutical Council, [17 May 2012]. 18 Council for Healthcare Regulatory Excellence, (2009) Advanced Practice: Report to the four UK Health Departments 17/ The Pharmacy Order 2010 draft legislation, Available: [17 May 2012]. 12

13 Pharmaceutical Services Negotiating Committee. How the career of a registered professional develops Traditionally, professional development in health professions has largely been seen as a linear, hierarchical process for an individual, i.e. a professional moving from a novice to expert practitioner (Figure 2). However, the importance of relational and contextual development is also now recognised, where practitioners professionally develop horizontally, as well as vertically. This expanded focus has resulted in more hybrid and diverse career pathways within professions. Figure 2. Process of an individual moving from novice to expert practitioner (the early years in practice) 20 D. Expert practitioner is able to understand professional issues intuitively and makes sound judgements in complex and unusual situations, safely and with appropriate input from colleagues but without routine referral C. Proficient practitioner (new registrant) is competent to practise against robust standards set by the regulator and has a holistic view of practice that is underpinned by analysis and problem solving B. Advanced beginner (pre-registration trainee) can identify important aspects of a professional situation and begins to contextualise application of their knowledge A Novice (the student/trainee) acquires the core knowledge skills, attitudes and behaviours which form the foundation for professional practice The transformation that an individual experiences during their pre-registration education and training and early years in practice takes them to the point of being safe, effective, independent, expert practitioners. Milestones are assessed against proficiency and performance, as opposed necessarily to academic qualification21 and journey lengths vary depending on individual circumstances. Teaching and learning styles change markedly as the level of practice develops; and experiential learning becomes increasingly appropriate. Maintenance of a reflective CPD portfolio can be a useful learning approach and often provides the basis for assessments.22 The final step of reaching expert practitioner is characterised by maturing judgement 20 Benner P. (1984) From Novice to Expert; Uncovering the knowledge embedded in clinical practice. Addison Wesley, California; as cited in PRLOG, Regulatory Development and Support Work stream, Assessing professional competence and proficiency: managing and assuring quality of practice through accreditation and credentialing, Paper PRLOG 4/5. 21 PRLOG, Regulatory Development and Support Work stream, Assessing professional competence and proficiency: managing and assuring quality of practice through accreditation and credentialing, Paper PRLOG 4/5. 22 PRLOG, Regulatory Development and Support Work stream, Assessing professional competence and proficiency: managing and assuring quality of practice through accreditation and credentialing, Paper PRLOG 4/5. 13

14 and embedding professionalism a progression that can only take place once registration is achieved and practise is independent. Traditionally in pharmacy, this final step is not formally recognised in professional or regulatory terms.23 For some practitioners there will be further progression from expert practitioner to advanced practitioner. The extent to which different levels of expert, specialist and advanced/specialist practitioners are identified either by employers, a professional organisation, a commissioning body or a regulator, and how competence at each level is assessed (either formally or informally) varies widely. Development needs vary for professionals at different stages in their career. Although higher education and achievement of qualifications has an important role to play in CPD and the initial foundation of higher level skills, there are a number of other methods and contexts, including employment, in which education, training and more informal development of higher level skills, knowledge and understanding is developed. 23 PRLOG, Regulatory Development and Support Work stream, Assessing professional competence and proficiency: managing and assuring quality of practice through accreditation and credentialing, Paper PRLOG 4/5. 14

15 2.1 Career pathways of registered pharmacy professionals Current arrangements for education, training and registration of pharmacists The current arrangements for education, training and registration of the vast majority of pharmacists in England comprise a four-year Masters-level undergraduate degree (Master of Pharmacy or MPharm degree) followed by a separate one-year workbased pre-registration training year, which is competence-based and the responsibility of the regulator: the General Pharmaceutical Council (GPhC). The regulator also operates an end of training year examination. The number of schools of pharmacy in England increased from 12 in 1999 to 21 in 2009 and pharmacy student numbers over the same period rose from 4,200 to 9, In the five years from 2004/05 to 2008/09, the number of students entering the first year of MPharm programmes increased by over 40%. This compares with a national increase in the numbers of first year university students of around 15%. 25 Securing a pre-registration placement position is currently the responsibility of the student and there is free movement of students across the UK for pre-registration placements. The number of pre-registration practice placements is not commissioned or fixed by the regulator, the Department of Health or universities, and there is speculation that the increasing numbers of graduates may experience difficulty finding placements in the future and may not be able to register. The MPC proposals for a five-year integrated MPharm with formal partnerships between universities and employers would help address this issue. The new GPhC educational standards (2011) 26 cover both the undergraduate degree and the pre-registration placement so there is now a greater connect between the academic and practice elements of pre-registration education and training. In its proposals for reform 27 which were submitted to the Secretary of State for Health in June 2011, MPC also highlighted the need to integrate the practice and academic elements of pharmacy pre-registration education and training to further improve delivery of new services and patient care by newly registered pharmacists. Latest figures indicate that there are currently 45, pharmacists on the register. In 2010, 58.1% of all registered pharmacists were female, with women outnumbering men by over 8,000. Among newly qualified pharmacists who joined the register for the first time in 2010, almost two-thirds (63.7%) were female. Data from the 2010 pharmacy register shows that 55.9% of registered female pharmacists are 39 years old or younger. This presents a potential risk, as women 24 Royal Pharmaceutical Society of Great Britain, (2009) personal communication. 25 Higher Education Statistics Agency, (2010) Students in Higher Education Institutions, Statistical First Release 142, Table 2a. 26 General Pharmaceutical Council (May 2011), GPhC Standards for the initial education and training of pharmacists, Available: [21 Jun 2012]. 27 Smith, A. and Darracott, R. (Apr 2011) Modernising Pharmacy Careers Programme, Review of pharmacist undergraduate education and pre-registration training and proposals for reform, Report to Medical Education England Board. 28 General Pharmaceutical Council (2012), data supplied directly on 14 th February

16 of this age will be more likely to take maternity breaks and consider part time/portfolio working. Analysis performed by Seston and Hassell 29 on the 2010 Workforce Census indicates that 10.6% of registered pharmacists are aged 60 or over, with a number of pharmacists working well into their 60s and 70s. Coupled with the increasing feminisation of the pharmacy workforce and high levels of part time and portfolio working, this may present a potential risk to workforce continuity. However, this must be considered in light of increasing numbers of pharmacy students and changing work practices. Data from the most recent workforce census in 2008 indicates that community pharmacy still accounts for the employment of the largest proportion of pharmacists, with 71% of those actively employed within the pharmacy profession working in the community sector. 30 The corresponding figures for hospital, primary care, industry and academic were 21.4%, 7.2%, 4.1% and 2.8% respectively. Current arrangements for education, training and registration of pharmacy technicians From 1 July 2011 it has been mandatory for pharmacy technicians to be registered healthcare professionals, regulated by the GPhC 31, and Pharmacy Technician has become a protected title. A transitional period for registration has been in place since the RPSGB opened a voluntary register in Latest figures indicate that there are currently 20,542 pharmacy technicians on the register 32 - a significant increase on the December 2009 figure of 8,256. Prior to mandatory registration, some 24 different pharmacy technician qualifications 33 were recognised by the GPhC as eligible to support applications for registration. Course providers are not accredited by the GPhC. The current qualifications now required for individuals to register as a Pharmacy Technician with the GPhC 34 are the Level 3 Qualifications and Credit Framework (QCF) Diploma in Pharmacy Service Skills (a National Vocational Qualification (NVQ)), and the Diploma in Pharmaceutical Science. Some employers, dependant on funding, access these via the Apprenticeship Framework 35. Up to 30 June 2011, temporary grandparenting arrangements made registration with the GPhC possible for trained and experienced pharmacy technicians who did not hold a new GPhC-approved qualification, but who had been working as pharmacy technicians and were deemed competent by their supervising pharmacist. 29 Seston, L. and Hassell, K. (2011) Briefing Paper: RPSGB Register Analysis 2010, Manchester: Centre for Pharmacy Workforce Studies, University of Manchester. 30 Seston, L. and Hassell, K. (July 2009), Pharmacy Workforce Census 2008: Main findings Centre for Pharmacy Workforce Studies Centre for Pharmacy Workforce Studies, School of Pharmacy & Pharmaceutical Sciences, University of Manchester, Available: [20 Jun 2012] 31 General Pharmaceutical Council, I am a Pharmacy technician, Available: [20 Mar 2012]. 32 General Pharmaceutical Council (2012), data supplied directly on 14 th February General Pharmaceutical Council guidance document, Criteria for initial registration as a pharmacy technician, Available: [20 Mar 2012]. 34 General Pharmaceutical Council guidance document, Criteria for initial registration as a pharmacy technician, Available: [20 Mar 2012]. 35 Skills for Health, (2010) Pharmacy Apprenticeship Framework; Level 2 and Level 3, Available: [20 Mar 2012]. 16